Organization
PREMIER DENTAL OF SOUTH ORANGE COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIAN S BRADFORD DDS (DENTIST/OWNER)
(949) 831-0051
Entity
Organization
Contact information
Practice address
24541 PACIFIC PARK DR STE 240, ALISO VIEJO, CA 92656-3050
(949) 831-0051
(949) 831-0037
Mailing address
24541 PACIFIC PARK DR STE 240, ALISO VIEJO, CA 92656-3050
(949) 831-0051
(949) 831-0037
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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